Communication and the Patient Experience
"Just Say No" is the slogan for the old drug prevention campaign during the 80s and 90s. Perhaps it should be the new slogan for insurance companies as they decide who receives what drugs.
There is a conflict currently within the healthcare industry - insurance companies make money by providing less, and providers make money by providing more. Often the patient finds themselves stuck in the middle, fighting for what they, or their doctors, think is the right treatment for them. Recently my son returned to California from being at boarding school in Colorado. He has some emotional issues and is on anti-anxiety medicine. The medicine was paid for by our Kaiser insurance. But upon his return to CA, the medication was refused by the insurance company. The pharmacy intern "explained" to me that each state did things differently.
The explanation was meaningless to mean. Fortunately, a helpful customer service person explained the differences in coverage from CA to CO. Why there would be a difference is beyond me. At least at the end of the conversation, I understood s a way forward rather than a dead-end "no."
The only thing I can think of to resolve these types of problems is more effective communication within the healthcare industry as a whole, but also between providers, insurance companies, and the patient. A willingness to say, "Yes, we can help," rather than "No, you have no other options" would help enormously. Even though the system may not be right, we can use the power of communication to try and help the patient to feel heard and to come up with solutions. Here are some ideas:
1. Listen - "Most people do not listen with the intent to understand - they listen with the intent to reply." - Stephen R. Covey. Active listening does not mean you are merely hearing the other person while preparing and waiting for your turn to speak. You can show you are listening, by paraphrasing back, making eye contact, and knowing when it's best not to speak at all.
2. Be Compassionate - Let the patient know you're seeking to understand by asking questions, rather than making assumptions about the patient or the system. Learn how to express empathy for one another - put yourself in their shoes. As someone with a son who is reliant on a specific medication, this issue is important to us. A little compassion can go a long way during a stressful situation.
3. Be Present - Be with the patient during their time of need. Working long hours, tending to multiple patients, maybe even skipping a lunch break to make enough time to see everyone is common. Practicing medicine these days can be taxing. But it's still important to remain present and "be" with a patient - not just physically, but mentally too.
4. Ask Questions - In dealing with our issue, the intern didn't ask any questions. Her lack of engagement made me feel as though she wasn't interested in hearing what we had to say. CO paid, and CA didn't. That was all she thought she needed to know. Being curious is good for the patient and your soul. A lot of problems are simpler to fix when we ask questions rather than thinking we have all the answers.
5. Look for Solutions - Eventually, I found out that our insurance in CA will not cover the 24-hour release formula of the medicine in question. Insurance in CO will cover this same medicine. We weren't told there were other options and wound up paying a steep price for what we thought was the only solution. If the pharmacy intern had presented us with suggestions, we could have checked with his doctor or the insurance company for a cheaper solution. We could have gotten enough for one week, instead of a full set while we waited on the updated insurance covered prescription from my son's doctor.
6. FINALLY - Be Authentic - In conflict, I've noticed that people believe if they put on a smile, it will help the situation. I feel the opposite. Putting on a fake smile and "positive" attitude isn't doing anyone justice as most people can tell that it's disingenuous. Honesty, even if it's showing that you're concerned or unsure, is more authentic than a smile. Healthcare providers don't need to know ALL the answers, but they should be willing to work with the patient to figure them out.
Effective communication is imperative to improving the patient experience. Learning how to listen, being compassionate, and offering a helping hand when seeking solutions rather than turning a cold shoulder and saying "NO" can go a long way.